Original version presented by: Bonnie Strickland, PhD HHS/HRSA/MCHB/DSCSHN August 9, 2014
MCHB’s Goal for Vision Screening Achieve universal screening of all young children according to established guidelines of the AAP, USPSTF, EPSDT and Healthy People 2020 and Prevent Blindness America. Support the public health role in assuring a continuum of eye care for young children within the healthcare delivery system and the medical home. Support the development of public health infrastructure to achieve universal screening and appropriate intervention
Broader CYSHCN System Agenda Partnerships with families and youth, Access to care through the medical home, Adequate financing, Early and continuous screening, Organization of services for easy use, Transition to adult health care.
Strategies Significantly increase the proportion of children identified with vision problems prior to school entry, Integrate vision screening in electronic health records, Establish vision care as a covered benefit for all children in all states, Establish a national collaborative of states engaged in implementation of universal vision screening.
Some Achievements Thus Far Affordable Care Act Essential Benefits, New items on the National Survey of Children’s Health (NSCH), Electronic Health Records, National Quality Forum Endorsed Measure for Vision Screening, Quality Improvement Methodology/Emphasis on Impact. Guidelines developed and almost ready for release. Many more….
Going Forward: MCH Transformation Focus on defining the public health role of our programs in measurable terms. Ensure that every child, no matter where he/she lives, or what his/her circumstances has equal access to vision screening and eye care. Identify solutions with proven effect that are available to some, but feasible for all. Identify the “game-changer” that MCH can support to realize widespread, measurable impact in a relatively short amount of time.
Transformation of MCH Watch Dr. Lu’s video on Transformation of the MCH Block Part II. http://mchb.hrsa.gov/blockgrant/index.html All discretionary grant programs supported through MCHB are part of the larger transformation.
State MCH Needs Assessment State Title V 5 Year Needs Assessments in progress now. Good time to contribute to Public Input component. Vision Screening is not one of the 15 new National Performance Measures, but states have the option to include vision screening as a state performance measure. The National Survey of Children’s Health provides a national data source, with state estimates.
Going Forward: Measurable Impact HRSA plans to reduce the number of “national centers” by more than ½ by 2015: Reduce or consolidate long-standing activities whose continuing primary purpose is to convene groups, develop and disseminate tools, training, awareness. Maintain those with high impact whose purpose is to directly influence health care of the population served. Looking for numerator and denominators; Data sources; Baselines and run charts.
Going Forward: Medical Home Medical home is an opportunity to assure that every child receives appropriate vision screening prior to school entry. Documentation in the child immunization record provides a strategy to assure screening prior to school entry. Pediatric Electronic Health Record (EHR) provide a mechanism for monitoring progress. The AAP EQIPP QI program is a mechanism to prepare pediatricians to do appropriate screening.
New/Emerging National Initiatives Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Early Childhood Comprehensive Systems (ECCS), Early Hearing Detection and Intervention (EHDI) Multi-agency initiatives to address early childhood issues: i.e. Birth-to Five: Watch Me Thrive Opportunity to link vision screening to each of these programs.
Contact Information Bonnie Strickland, Ph.D. Director, Division of Services for Children with Special Health Care Needs 301-443-9331 bstrickland@hrsa.gov Linda McElwain, BSN Unit Manager, Maternal and Child Health Public Health Division/Wyoming Department of Health 307-777-6326 linda.mcelwain@wyo.gov
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